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目的 探讨高频超声对男性不育患者阴囊疾病的诊断价值。方法 回顾性分析2014年1月—2016年1月北京大学第三医院非性功能障碍的男性不育症患者阴囊高频超声检查结果及图像特点,主要包括睾丸、附睾、输精管阴囊部、睾丸鞘膜腔及精索静脉的形态结构、内部回声及血流动力学等信息。结果 共选择男性不育症患者1645例,高频超声检查显示阴囊异常发生率为76.8%(1264例)。其中睾丸异常发生率为35.0%(575例),包括睾丸体积小249例(15.1%)、睾丸实质回声不均匀95例(5.8%)等;附睾异常发生率为59.9%(986例),包括附睾囊肿582例(35.4%)、附睾体积增大153例(9.3%)等;输精管阴囊部异常发生率为1.8%(29例),包括输精管阴囊部增粗、扩张、狭窄、闭塞;睾丸鞘膜腔异常发生率为4.4%(73例),包括睾丸鞘膜腔积液52例(3.2%)和睾丸鞘膜腔结石21例(1.3%);精索静脉曲张发生率为34.5%(567例),包括左侧396例(24.1%)、双侧147例(8.9%)、右侧24例(1.5%)。结论 高频超声可以清晰显示睾丸、附睾、输精管阴囊部、睾丸鞘膜腔和精索静脉正常及异常声像图,对男性不育症者进行阴囊高频超声检查,有助于临床获得部分先天及后天影响男性不育疾病的诊断和治疗依据。
Objective To investigate the diagnostic value of high frequency ultrasound in scrotal diseases in male infertility patients. Methods The results of scrotal high-frequency ultrasonography and imaging features of male infertility patients with non-sexual dysfunction in Peking University Third Hospital from January 2014 to January 2016 were retrospectively analyzed. The main features included testis, epididymis, vas deferens scrotum, Membranous and varicocele morphological structure, internal echo and hemodynamics and other information. Results A total of 1645 male infertility patients were selected. High-frequency ultrasound showed that the incidence of scrotal abnormalities was 76.8% (1264 cases). The incidence of testicular abnormalities was 35.0% (575 cases), including 249 cases (15.1%) with small testes and 95 cases (5.8%) with uneven testicular echoes. The incidence of abnormal epididymis was 59.9% (986 cases), including Epididymal cyst 582 cases (35.4%), epididymal volume 153 cases (9.3%); vasectasia abnormalities were 1.8% (29 cases), including vas deferens scrotum thickening, expansion, stenosis, occlusion; The abnormal incidence of membranous cavity was 4.4% (73 cases), including 52 cases of testicular hydrocele (3.2%) and 21 cases of testicular hydrocele (1.3%). The incidence of varicocele was 34.5% (567 Including 396 cases (24.1%) on the left, 147 cases (8.9%) on both sides and 24 cases (1.5%) on the right. Conclusion High-frequency ultrasound can clearly show the normal and abnormal sonogram of testis, epididymis, vas deferens scrotum, testicular sheath and varicocele, and scrotal high-frequency ultrasound examination of male infertility is helpful to obtain some of the innate And the prognosis of male infertility diagnosis and treatment basis.